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Acute Limb Ischemia Due to Arterial Thrombosis Associated With Coronavirus Disease 2019
Krishnan Warrior1, Paul A Chung1, Nida Ahmed2
1Division of Pulmonary and Critical Care, Department of Medicine, Loyola University Health System, Stritch School of Medicine, Maywood, IL.
Insights
Coronavirus disease 2019 (COVID-19) can cause arterial thrombosis leading to acute limb ischemia. Vigilant monitoring of d-dimer levels is crucial for early detection and management of these severe thrombotic events.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Cardiology
Background:
- Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state.
- Thrombotic events are a known complication of severe COVID-19 infections.
- Acute limb ischemia (ALI) is a critical vascular emergency.
Objectives:
To describe a case of acute limb ischemia caused by arterial thrombosis due to coronavirus disease 2019.
Design:
Clinical observation of a patient.
Setting:
Academic medical center.
Patient:
A 59-year-old female with history of hypertension, hyperlipidemia, and prior smoking.
Intervention:
Clinical observation and data extraction from electronic medical records.
Measurements And Main Results:
We report a case of peripheral arterial thrombosis associated with coronavirus disease 2019, resulting in acute limb ischemia of the right lower extremity. This event was heralded by a sudden and significant elevation in d-dimer levels. At the time of surgery, a long, gelatinous clot was retrieved from the right popliteal artery. Perioperatively, she continued to have absent pedal Doppler signals and after multiple embolectomy attempts, required distal arterial cut down with removal of additional thrombi and resultant improvement of distal arterial flow.
Conclusions:
This case demonstrates the importance of regularly checking d-dimer levels and vigilant monitoring for arterial thrombotic events, as they can rapidly become catastrophic.
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